| Spectrum House, Inc | |
|
4673 E Highway 20 Niceville FL 32578-9796 | |
| (850) 607-6910 | |
| Not Available |
| Full Name | Spectrum House, Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4673 E Highway 20, Niceville, Florida |
| Authorized Official Name and Position | Tyler Russell Steverson (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8506076910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum House, Inc 9900 N Davis Hwy Pensacola FL 32514-8124 Ph: () - | Spectrum House, Inc 4673 E Highway 20 Niceville FL 32578-9796 Ph: (850) 607-6910 |
| NPI Number | 1144954736 |
|---|---|
| Provider Enumeration Date | 07/11/2022 |
| Last Update Date | 07/11/2022 |
| Certification Date | 07/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144954736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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